| 1.
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Provided that the funds are available
under the budget, the appropriations entered under the budget
heading ‘Supplementary aid for the disabled’, to be used in
accordance with the conditions set out in these guidelines after
national aid and aid under the Staff Regulations have been claimed,
are intended to finance non-medical expenses arising from a
disability as defined in point 4.1.
The welfare unit of each institution shall guide and assist
applicants and recipients who so wish in their dealings with the
administration of their institution and with national
administrations.
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| 2.1. |
The decision to grant support under the
budget heading ‘Supplementary aid for the disabled’ shall be taken
within the institution responsible for the applicant by the
authority designated for that purpose, hereinafter referred to as
‘the Authority’.
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| 2.2. |
For the purpose of adopting any
decision under these guidelines and without prejudice to the opinion
of the medical officer provided for in point 4.3, the Authority may
seek the opinion of an ad hoc committee consisting of the
Institution’s medical officer, the social worker and the
administrator responsible for the case concerned, and, where
appropriate, two experts appointed by the Institution according to
the nature of the disability, hereinafter referred to as ‘the ad hoc
Committee’.
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| 2.3. |
For the purposes of these guidelines,
the Authority, the medical officer, the social worker, or the
administrator in charge shall be those of the Institution
responsible for the applicant or the person in receipt of aid.
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| 3.1. |
Provided that their disability has been
recognised in accordance with point 4.1 below, the following shall
be eligible for support under the budget heading ‘Supplementary aid
for the disabled’:
- officials and members of the temporary staff in active
employment;
- spouses of the persons specified in point (a), provided that
they are not in gainful employment or in receipt of income or
pensions deriving from an earlier occupation;
- children in respect of whom the dependent child allowance is
payable under the conditions set out in Article 2(2), (3), and (5)
of Annex VII to the Staff Regulations;
- children aged over 26 no longer eligible for the dependent
child allowance referred to
above, but in respect of whom tax is deductible under Regulation
(EEC, Euratom, ECSC) No 260/68 laying down the conditions and
procedure for applying the tax for the benefit of the European
Communities;
- orphans who have lost both parents in receipt of an orphan’s
pension within the meaning of Article 21 of Annex VIII to the
Staff Regulations.
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| 3.2. |
To guarantee continuity of benefits, a
pensioner or person in receipt of a termination of service allowance
or an invalidity allowance who, when in active employment, received
supplementary aid for the disabled in his/her own right or in
respect of his/her spouse and was reimbursed accordingly for
expenses incurred in the two years preceding his/her retirement or
the termination of his/her service shall continue to receive that
aid from his/her parent institution under the conditions set out in
these guidelines.
The aid shall be granted to a pensioner’s spouse provided that
he/she is not in gainful employment or in receipt of income or
pensions deriving from an earlier occupation.
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| 4.1. |
A person shall be considered disabled
if he/she is suffering from severe deficiencies, disabilities, or
handicaps resulting from physical impairment, including sensory,
mental, or psychological impairment, which limit or impede
integration or prevent the person from performing an activity or
function considered normal for a human being.
To be eligible for financial support, the person concerned must be
at least 30% physically disabled and/or at least 20% mentally
disabled according to the evaluation of the Institution’s medical
officer based on the scale laid down by the Interinstitutional
Medical Board.
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| 4.2. |
The application for recognition of a
disability must be submitted to the Authority. It shall include a
detailed assessment by the person concerned or his/her
representative of the measures necessary to offset the effects of
the disability and facilitate social integration. It shall be
submitted together with a medical report, under sealed cover, by the
person’s doctor, which, in so far as this is possible, shall propose
a degree of physical and/or mental invalidity.
The Authority shall forward the medical report to the medical
officer for an opinion.
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| 4.3. |
After examining the disabled person, if
he/she thinks it necessary, and on the basis of point 4.1., the
medical officer shall
- establish that the minimum threshold specified in point 4.1 is
met,
- determine the period of validity of his/her opinion.
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| 4.4. |
After obtaining the opinion of the
medical officer, the Authority may consult the ad hoc Committee,
which shall assess the social integration problems resulting from
the disability and deliver an opinion on the measures advocated by
the person concerned or his/her representative to offset its
effects.
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| 4.5. |
The Authority shall take its decision
on the basis of the medical officer’s opinion and, where applicable,
the opinion of the ad hoc Committee. The decision shall specify the
services to be covered by the financial support granted by the
Institution. It shall be notified to the person concerned or his/her
representative.
The decision shall be renewed under the same conditions as it was
adopted.
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| 5.1. |
The following may be covered by an
application for direct billing or reimbursement under the budget
heading ‘Supplementary aid for the disabled’ under the conditions
set out in point 8 below:
- costs of residence (including board and lodging, and service
and other charges) in an institution or home for the disabled
approved by the proper national authorities, after deduction,
where applicable, of the expenses reimbursed by the Joint Sickness
Insurance Scheme (JSIS);
- costs of education or specific training considered necessary
to offset the effects of the disability;
- costs of care by a qualified home nurse, after deduction of
the amounts reimbursable by the JSIS;
- other costs incurred in duly justified nursing care administered
under the responsibility of the applicant’s doctor.
- The disabled person’s transport expenses linked directly to
the expenses referred to in points (a) and (b) above shall be
reimbursed, up to a maximum of €2 000 a year and on presentation
of sound documentary evidence, on the basis of the first-class
rail fare or the economy-class air fare. The Authority may,
however, decide to exceed the above ceiling on a proposal from the
ad hoc Committee adopted unanimously.
The costs of transport by private car, when the disabled person
lives in the family home, shall be defrayed on presentation of a
certificate issued by the care or education institution confirming
that there is no organised transport system or of a certificate
issued by the disabled person’s doctor attesting that the disabled
person cannot use the transport system provided.
The expenses incurred in regular journeys between the family home
and the care or education institution shall be reimbursed at the
rate of €0.26 per kilometre for one round trip (two journeys) a
day, without exceeding the ceiling specified above.
Where a disabled person cannot use an appropriate service, whether
public or provided by the care or education institution, or a
private car for the journeys referred to above, the costs of
transport by taxi or a special vehicle shall be reimbursed, taking
into account the local market conditions and on the basis of a
prior estimate.
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| 5.2. |
If purchased after the date of entry
into force of these rules, given appliances may be eligible for
reimbursement according to a specific degressive scale based on
family income (see Annex I, ‘List of appliances’, and Annex II,
‘Scale’).
In any one calendar year, each recipient may be reimbursed for not
more than 55% of the cost of an appliance or replacement thereof, up
to a maximum amount of €13 154.55 (adjusted annually). Reimbursement
for an appliance may not be spread over several years. Repair costs
shall not be reimbursed. The need for replacement must be justified
by the fact that the appliance cannot be repaired or is not suited
to the disabled person’s needs.
Specific conditions for granting reimbursement
Reimbursement shall be granted
- on the basis of a detailed report by the disabled person’s
doctor demonstrating that the appliance is strictly necessary on
account of the seriousness of the disability or the urgent need
for replacement,
- on presentation of at least two estimates,
- after the Institution’s medical officer or, if expenses are to
be reimbursed by the JSIS, the medical officer of the Settlements
Office has delivered his/her opinion,
- after the disabled person has claimed all possible national
aid, which shall be taken into account when calculating the
financial support, and submitted documentary evidence of dealings
with and any aid granted by national administrations.
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| 6.1. |
Bills including expenses reimbursable
under the JSIS must be sent in the first instance to the Settlements
Office responsible for the recipient.
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| 6.2. |
Bills not including expenses
reimbursable under the JSIS must be sent directly to the welfare
unit of the Institution.
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| 7. |
Financial support from the Institution
shall be granted on presentation of original itemised bills
specifying the nature of the expenses incurred and the corresponding
amounts. Where it is impossible to supply itemised bills serving to
distinguish between medical and non-medical expenses, the
Settlements Office shall determine the portion chargeable to the
JSIS and, after setting the rate, forward the bill to the welfare
unit of the Institution responsible for the recipient.
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| 8.1. |
The recipient shall be reimbursed for
bills showing the expenses referred to in points 5.1 and 5.2
according to the scale reproduced in Annex II. Reimbursement shall
be granted after the recipient has claimed all possible national
aid, which shall be taken into account when calculating the
financial support. The recipient must submit documentary evidence of
dealings with and aid paid by national administrations (see point 1,
assistance from welfare units).
The scale shall allow for all monthly family income, namely :
- taxable earned income of the official/other servant and
his/her spouse;
- retirement, survivor’s, and orphan’s pensions and invalidity
pensions and allowances, maintenance, etc.;
- unemployment benefits;
- chronic sickness allowances;
- any pension, income, annuity, allowance, etc. paid from other
sources on account of the disability.
Bills must be submitted for reimbursement within three months of
being paid or sent to the person in receipt of aid.
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| 8.2. |
Expenses considered excessive or
related to services not required for practical purposes and/or
necessary to offset the effects of the disability shall be excluded
from reimbursement by decision of the Authority, after consulting
the ad hoc Committee, in accordance with the criteria laid down by
each institution.
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| 9.1. |
The following shall be deducted from
the amount of expenses incurred to be defrayed by the Institution :
- reimbursements of expenses obtained from another source under
any other national law or regulation; the recipient shall be
obliged to declare reimbursements and aid obtained from other
sources and supply the appropriate supporting documents;
- the additional education allowance granted by the Appointing
Authority and any similar national allowances obtained on account
of the disability.
The recipient’s entitlement to the dependent child allowance
(basic rate and increment) shall not be affected.
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| 9.2. |
The recipient shall be obliged to
declare any sums drawn under the heading of points 1 and 2 to the
appropriate department and supply the necessary supporting
documents.
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| 10. |
Any sum paid in error shall be
recovered if the recipient has been informed that the payment was
incorrect or the error was so obvious that he/she must have been
aware of it.
The recovery claim must be made no later than five years from the
date on which the sum was paid. This time limit may not be invoked
against the authority where the latter is able to establish that the
person concerned deliberately misled the administration in order to
be paid the sum in question.
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| 11. |
The institutions shall hold regular
consultations with a view to harmonising the application of these
guidelines.
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| 12. |
Thee guidelines shall enter into force
on 1 May 2004.
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